The Pill

Birth control pills
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Yep, It’s Totally Fine To Skip The Last Week Of Your Birth Control Pills

If you’re on birth control, there’s no reason you need to have your period.

It’s no secret: periods suck. Between the cramps, the fatigue, and the poops, a period is no one’s idea of a good time. So of course if you can skip them, why wouldn’t you? If you’re taking an oral contraceptive you might have asked yourself (or your best friends) before, can you skip the last week of birth control pills? It is possible to skip your period on the pill. Here, OB-GYNs answer all your burning questions about skipping the last week of birth control.

First things first: take a look at your birth control. There are monophasic, biphasic, triphasic, continuous, and extended cycle pills. You can take any of them continuously, experts say, but it’s helpful to know which type you’re taking.

Can you skip the last week of birth control pills?

Yes, it’s totally fine to bypass the placebo pills and start a new pack of birth control. There’s really no reason you have to have a period, OB-GYNs agree.

“It’s very safe, and it’s actually protective because we know that people who take oral contraceptive pills and cycle less every month, as in not ovulating every month, they have some amount of protection from ovarian cancer later on in life,” says Dr. Joanna Dalton Ayoung, M.D., an OB-GYN with Orlando Health Physician Associates.

“It’s certainly safe. You just might not know if you’d had an unintended pregnancy,” says Dr. Jennifer Howell, OB-GYN at Duke Health. “If you miss pills or you skip pills or you had a pill failure, you wouldn’t know you were pregnant is probably the only downside. The other thing that can sometimes happen is you can have breakthrough bleeding because the lining of your uterus is still being stimulated by hormones.”

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Ayoung says her patients have asked her if taking the pill continuously long-term will affect their ability to get pregnant later. She reassures them that it will not. “Once the birth control is stopped, your ovaries are going to start taking back over that hormonal control, and you’ll start ovulating,” she says.

Does it matter what type of birth control you’re on?

It’s safe to skip the placebo week on any kind of pill, Ayoung says. Some may just be more ideal for taking continuously than others.

“Monophasic are the best pills to take continuously as they have the same level of hormones in all the pills and lower the chances of bleeding or spotting when used continuously. Biphasic and triphasic pills try to mimic the natural variations in your hormone levels through your menstrual cycle, so these birth control pills have varying levels of hormones, making them more prone to spotting when used continuously,” she says.

You can tell your pill is biphasic or triphasic if each week of pills is a different color; in monophasic packs, the first three weeks of pills are all the same color, with just the placebo row looking different.

There are continuous birth control pills, which come packaged to be taken every day for a year without a break — basically, they take the work out of this whole process for you. You might also consider (or already be on) extended cycle pills, which you take continuously for 84 days, giving you about four periods a year, Ayoung explains.

Is it bad if you don’t have a period while on birth control?

You might have heard from a friend or even a doctor that skipping your last week of birth control is bad or unsafe in some way. Some people like having a period because they feel like they need it to “clean out” their uterus. And sure, if you imagine a bunch of old lining building up in there, it’s easy to understand why. But if you’re on birth control, you really do not need to have a period.

“When you’re on birth control pills, the high doses of estrogen and progesterone are thinning that lining out. So it’s not like lining is building up in there and you have to clean things out. That’s just a myth,” Howell says. “It’s confusing to people because it’s not good for you to not have a period when you’re not on [birth control]. If you went to the doctor’s and you hadn't had a period in six to eight months, that’s a problem. But when you’re on something that’s purposefully thinning out the lining of your uterus, there’s nothing there to shed.”

Can you skip the last week of your birth control every month?

You can skip the last week of your birth control pack once if you’d rather not have a period that month, or you can do it “every single month,” says Ayoung. Many gynecologists recommend taking your birth control (and skipping the last week) for three months before taking one week off to have a period, she explains. This allows any broken down uterine lining to clear out on a schedule, instead of maybe causing some unexpected spotting at other times.

If you start taking your birth control continuously long-term, you may experience breakthrough bleeding off and on or six to nine months, Howell says. Some people never have it, and others will continue having it long after the nine-month mark (it just depends on your body), so don’t throw out your pads and tampons right away.

And, if you’re trying to ensure you don’t have your period on your wedding day or for a special event of some kind, start this process way ahead of time. “When we first get someone started on a method that is designed to ultimately result in minimal to no periods, there is going to be sort of a getting used to it three to six, even nine-month period sometimes, where you could have unpredictable breakdown bleeding. If you have this big event or something that it would devastate you to have breakthrough bleeding, don’t make the first time you do this be that week,” says Howell.

Are there side effects to taking your birth control continuously?

There really aren’t any, according to Howell and Ayoung, other than that occasional spotting or breakthrough bleeding. Again, not everyone experiences this anyway, but if you do, don’t be alarmed.

What’s the best birth control if you don’t want a period?

There’s nothing wrong with taking your birth control and always skipping the sugar pills, Ayoung says, but there are other birth control methods that can take away your period with less hassle.

“If you’re looking for method where you just set it and forget it, and you have no periods until you’re ready to become pregnant, then I would say a more convenient way of doing that is an IUD or Nexplanon. That being said, all birth control pills can be used continuously,” Ayoung says (though she does note that birth control patches should not be used continuously — it exposes the wearer to too much estrogen).

If you plan to stay on the pill long-term and just skip the final week of pills each month, be sure to tell your doctor. Your OB-GYN will need to write your prescription specifically so that you don’t get ahead of schedule on your refills with your pharmacy and insurance carrier. “You have to have your doctor write it so that it says to dispense three packs with four refills so that you have enough for the year,” says Howell. Or, you could ask your doctor about a continuous birth control pill that comes packaged without any of the placebo weeks at all.

Your provider can also confirm that your pill is OK to take daily — triphasic pills (like Ortho Tri-Cyclen) are more likely to lead to breakthrough bleeding when taken continuously, Howell says, while monophasic ones tend to work better. As always, it’s best to talk to your doctor before changing up your birth control regimen. Together, you two can take into account any relevant medical history and answer your specific questions before you make any changes.

Experts:

Dr. Joanna Dalton Ayoung, M.D., OB-GYN at Orlando Health Physician Associates

Dr. Jennifer Howell, OB-GYN at Duke Health